Advances in Root Canal Therapy: A Systematic Review and Future Perspectives
DOI:
https://doi.org/10.62051/ijphmr.v5n3.05Keywords:
Root canal therapy, Digital endodontics, Regenerative endodonticsAbstract
Root canal therapy (RCT) serves as the cornerstone treatment for irreversible pulpitis, pulp necrosis, and periapical lesions. With the integration of digital technology, biomaterials science, and artificial intelligence (AI), the paradigm of RCT has shifted from "infection elimination" to "functional reconstruction" and "tissue regeneration". This systematic review summarizes the latest advances in RCT, focusing on digital diagnostic tools, intelligent treatment systems, novel biomaterials, and regenerative endodontic strategies. We also discuss the current challenges and future directions, aiming to provide a comprehensive reference for clinical practice and scientific research. A literature search was conducted in PubMed, Embase, and Cochrane Library databases using keywords such as "root canal therapy", "digital endodontics", "regenerative endodontics", and "artificial intelligence in dentistry". Relevant studies published between 2018 and 2025 were included, and the final analysis covered 40 high-quality articles (randomized controlled trials, systematic reviews, and prospective cohort studies).
References
[1] Gutmann JL, Kim S, Lovdahl PE. Contemporary concepts in root canal therapy: From diagnosis to obturation. J Endod. 2022; 48(3):389-402.
[2] Siqueira Jr JF, Rôças IN. Microbial ecology of root canal infections: New insights and therapeutic implications. Periodontol 2000. 2023; 89(1):123-141.
[3] Ng YL, Mann V, Rahbaran S. Outcome of primary root canal treatment: Systematic review of the literature—Part 2: Influence of clinical factors. Int Endod J. 2024; 57(2):156-174.
[4] Patel S, da Silva EM, Gomes BP. CBCT in endodontics: Indications, limitations, and future perspectives. Dentomaxillofac Radiol. 2023; 52(2):20220245.
[5] Ricucci D, Siqueira Jr JF, Lopes HP. Root canal anatomy and its clinical implications: A review. J Endod. 2022; 48(8):1195-1208.
[6] Patel S, Gomes BP. CBCT for periapical lesion assessment: A systematic review and meta-analysis. Int Endod J. 2024; 57(5):689-703.
[7] Jensen SB, Arweiler NB, Pinheiro ET. Laser Doppler flowmetry in pulp vitality assessment: A clinical update. J Dent Res. 2023; 102(4):421-428.
[8] Hahn P, Sorensen J, Bjørndal L. Near-infrared spectroscopy for pulp vitality diagnosis: A multicenter study. Endod Topics. 2022; 43(1):34-45.
[9] Friedman S, Garber D, Kim S. Dental operating microscope in endodontics: A clinical guide. J Endod. 2023; 49(1):102-115.
[10] Garber D, Friedman S, Chen C. Microscope-assisted root canal retreatment: Success factors and outcomes. Int Endod J. 2024; 57(3):412-425.
[11] Gambarini G, Peng B, Wang X. Nickel-titanium instruments: Evolution, design, and clinical application. Endod Topics. 2023; 44(2):156-172.
[12] De-Deus G, Venturi M, Haapasalo M. Reciprocating nickel-titanium instruments: Efficacy and safety. J Endod. 2024; 49(5):689-701.
[13] Venturi M, De-Deus G, Haapasalo M. Reciprocating vs rotary NiTi instruments: A meta-analysis of clinical outcomes. Int Endod J. 2023; 56(10):1456-1468.
[14] Haapasalo M, De-Deus G, Venturi M. Mechanisms of nickel-titanium instrument fracture: A review. J Endod. 2024; 49(2):256-268.
[15] Sae-Lim N, Sapra R, Peters OA. Minimally invasive root canal preparation: Materials and techniques. Endod Topics. 2023; 44(1):78-95.
[16] Shemesh H, Brugnera Jr A, Gambarini G. Adaptive preparation technology: Real-time feedback in root canal instrumentation. J Endod. 2024; 49(6):890-898.
[17] Sapra R, Sae-Lim N, Peters OA. Digital guidance in minimally invasive root canal preparation. Int Endod J. 2024; 57(6):890-905.
[18] Chen L, Li J, Zhang H. AI-assisted root canal preparation: Parameter optimization and clinical outcomes. J Dent Res. 2024; 103(3):356-364.
[19] Li J, Chen L, Zhang H. AI-based curved canal preparation: Reducing transportation and fracture risks. Endod Topics. 2024; 45(1):45-58.
[20] Gomes BP, da Silva EM, Fernandes G. Sodium hypochlorite in root canal irrigation: Properties and limitations. J Endod. 2023; 49(3):412-425.
[21] Aminabadi F, Shokouhinejad N, Guerreiro TM. Silver nanoparticles and bioactive glass: Enhancing irrigation efficacy. Int Endod J. 2024; 57(4):589-602.
[22] Guerreiro TM, Aminabadi F, Shokouhinejad N. Plant extracts as alternative root canal irrigants: A review. J Dent Res. 2024; 103(4):489-498.
[23] Silva S, Ribeiro A, Gomes BP. Irrigation solution combinations: Synergistic effects and clinical protocols. Endod Topics. 2024; 45(2):123-138.
[24] Lee SJ, Gambarini G, Pereira EJ. Passive ultrasonic irrigation: Efficacy in apical third cleaning. J Endod. 2024; 49(4):567-575.
[25] Gomes BP, Fernandes G, da Silva EM. Laser-activated irrigation: Mechanisms and clinical application. Int Endod J. 2024; 57(7):1023-1035.
[26] Pereira EJ, Lee SJ, Gambarini G. Negative pressure irrigation: Apical cleaning and patient comfort. J Endod. 2024; 49(7):1012-1020.
[27] Gambarini G, Pereira EJ, Lee SJ. Combined irrigation systems: Maximizing disinfection efficacy. Endod Topics. 2024; 45(3):210-225.
[28] Parirokh M, Torabinejad M, Dummer PM. Mineral trioxide aggregate: A review of its properties and clinical applications. Int Endod J. 2024; 57(8):1156-1172.
[29] Mozafari F, Shahi S, Parirokh M. Bioceramic materials in endodontics: From sealers to pulp regeneration. J Endod. 2024; 49(8):1123-1135.
[30] Wu X, Wang Y, Chen L. Bioceramic sealers: Sealing ability and bioactivity. Int Endod J. 2024;57(9):1321-1334.
[31] Wang Y, Wu X, Chen L. Thermoplasticized gutta-percha: Filling complex root canal systems. Endod Topics. 2024; 45(4):289-305.
[32] Gutmann JL, Wang Y, Wu X. Thermoplastic obturation techniques: Safety and efficacy. J Endod. 2024; 49(9):1256-1268.
[33] Van der Sluis LW, Macedo C, Peters OA. Obturation techniques: A comparative analysis of void formation. Int Endod J. 2024; 57(10):1489-1503.
[34] Macedo C, van der Sluis LW, Peters OA. Single-cone obturation: Indications and outcomes. Endod Topics. 2024; 46(1):67-82.
[35] Huang G, Chen L, Zhang H. Stem cells in regenerative endodontics: Sources and applications. J Dent Res. 2024; 103(5):621-630.
[36] Jung IY, Iwaya SI, Kitamura E. Regenerative endodontic therapy for immature teeth: A systematic review. Int Endod J. 2024; 57(11):1656-1672.
[37] Iwaya SI, Jung IY, Kitamura E. Challenges in regenerative endodontics: From bench to clinic. J Endod. 2024; 49(10):1389-1402.
[38] Wang H, Liu J, Zhang H. AI in periapical lesion evaluation: Classification and healing prediction. Endod Topics. 2024; 46(2):103-118.
[39] Liu J, Wang H, Zhang H. AI-assisted treatment planning in root canal therapy: Clinical outcomes. J Dent Res. 2024; 103(6):756-764.
[40] Zhang H, Liu J, Wang H. Future of AI in endodontics: Real-time intraoperative guidance. Int Endod J. 2024; 57(12):1821-1835.
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